OBJECTIVETo explore the effect of signal strength indictor (SSI) in improving sensitivity of China Infectious Diseases Automated-alert and Response System (CIDARS).

METHODSDiarrhea cases in 2007-2011 and early warning signals in 2010-2011 were selected by using random digital table method. Then, SSI and event-related ratio (ER) were calculated. The relationship between ER and SSI was analyzed, and the effect of SSI on ER was explored by using multiple logistic regression analysis.

RESULTS9 620 early warning signals in 2010-2011 were generated in two years. Of these, 74, or 0.77% were defined as suspected outbreak signal. The median of SSI related with suspected outbreak signal was 4.0, which was much higher than non-suspected outbreak signal (1.7). ER was significantly correlated with SSI (r=0.917). SSI classification has a good correlation between the ER, ER exceeded 20 after SSI reached 20. The multivariate logistic regression analysis showed OR of SSI related with suspected outbreak signal was 2.52 (95% CI 2.04-3.12). Compared with non-epidemic season, the relationship of SSI and ER in epidemic season was much higher.

CONCLUSIONSSI was closely related with ER. The relationship was much closer in large scale outbreak and epidemic season, and compared to non-epidemic,the effect of epidemic season is more obvious.

China ; Communicable Diseases ; diagnosis ; epidemiology ; Diarrhea ; diagnosis ; epidemiology ; Disease Outbreaks ; Humans ; Population Surveillance

BACKGROUND AND PURPOSE: Encephalitis caused by Listeria monocytogenes (L. monocytogenes) is rare but sometimes fatal. Early diagnosis is difficult using routine cerebrospinal fluid (CSF) tests, while next-generation sequencing (NGS) is increasingly being used for the detection and characterization of pathogens. METHODS: This study set up and applied unbiased NGS to detect L. monocytogenes in CSF collected from three cases of clinically suspected listeria meningoencephalitis. RESULTS: Three cases of patients with acute/subacute meningoencephalitis are reported. Magnetic resonance imaging and blood cultures led to a suspected diagnosis of L. monocytogenes, while the CSF cultures were negative. Unbiased NGS of CSF identified and sequenced reads corresponding to L. monocytogenes in all three cases. CONCLUSIONS: This is the first report highlighting the feasibility of applying NGS of CSF as a diagnostic method for central nervous system (CNS) L. monocytogenes infection. Routine application of this technology in clinical microbiology will significantly improve diagnostic methods for CNS infectious diseases.
Central Nervous System ; Cerebrospinal Fluid ; Communicable Diseases ; Diagnosis ; Early Diagnosis ; Encephalitis ; Humans ; Listeria monocytogenes* ; Listeria* ; Magnetic Resonance Imaging ; Meningitis, Listeria ; Meningoencephalitis* ; Methods

OBJECTIVEProviding evidences for further modification of China Infectious Diseases Automated-alert and Response System (CIDARS) via analyzing the outbreak detection performance of Moving Percentile Method (MPM) by optimizing thresholds in different provinces.

METHODSWe collected the amount of MPM signals, response results of signals in CIDARS, cases data in nationwide Notifiable Infectious Diseases Reporting Information System, and outbreaks data in Public Health Emergency Reporting System of 16 infectious diseases in 31 provinces in Chinese mainland from January 2011 to October 2013. The threshold with the optimal sensitivity, the shortest time to detect outbreak and the least number of signals was considered as the best threshold of each disease in Chinese mainland and in each province.

RESULTSAmong all the 16 diseases, the optimal thresholds of 10 diseases, including dysentery, dengue, hepatitis A, typhoid and paratyphoid, meningococcal meningitis, Japanese encephalitis, scarlet fever, leptospirosis, hepatitis, typhus in country level were the 90(th) percentile (P90), which was the same as provincial level for those diseases.For the other 6 diseases, including other infectious diarrhea, influenza, acute hemorrhagic conjunctivitis, mumps, rubella and epidemic hemorrhagic fever, the nationwide optimal thresholds were the 80th percentile (P80), which was different from that by provinces for each disease. For these 6 diseases, the number of signals generated by MPM with the optimal threshold for each province was decreased by 23.71% (45 557), 15.59% (6 124), 14.07% (1 870), 9.44% (13 881), 8.65% (1 294) and 6.03% (313) respectively, comparing to the national optimal threshold, while the sensitivity and time to detection of CIDARS were still the same.

CONCLUSIONOptimizing the threshold by different diseases and provinces for MPM in CIDARS could reduce the number of signals while maintaining the same sensitivity and time to detection.

China ; Communicable Diseases ; Disease Notification ; Disease Outbreaks ; prevention & control ; Humans ; Population Surveillance ; methods

Objective To investigate the effect of 2-methoxyestradiol (2ME2) on phosphorylation of Tau protein (p-Tau) and mortor function of rats after spinal cord injury (SCI).Methods A total of 72 adult male Sprague-Dawley rats were randomly divided into 3 groups:sham-operated group (n=24),SCI group (n=24) and SCI+2ME2 treated group (n=24); models of SCI were created by modified Allen's method; one d after SCI,rats in the SCI+2ME2 treated group were given intraperitoneal injection of 2ME2 (24 mg/kg) for seven d,and rats in the SCI group were given the same volume of normal saline.Basso,Beatti,Bresnahan (BBB) scale was performed to evaluate the hindlimb function one,three,seven,14,21 and 28 d after SCI; the expression changes ofp-Tau (Ser 262) seven d after SCI were observed by immunofluorescence and Western blotting.Results BBB scale scores in the SCI group and SCI+2ME2 group were significantly increased following the prolonging of injury times (1-28 d of injury,P＜0.05); on the 7th,14th,21st and 28th d of injury,the scores in the SCI+2ME2 group were significantly higher than those in the SCI group (P＜0.05).The p-Tau positive cells in the spinal cord and the p-Tau (Ser 262) expression in the SCI group and SCI+2ME2 group were significantly increased as compared with those in the sham-operated group (P＜0.05),and those in the SCI+2ME2 group (19.05± 1.34 and 0.283±0.094) were obviously lower as compared with those in the SCI group (10.36±1.28 and 0.607±0.105,P＜0.05).Conclusion 2ME2 offers protection in rats with SCI by reducing the level of tau phosphorylation.